What ways can we elevate the conversation around prostate cancer to ensure early detection by those at risk?

Contributors Respond

Men's Health Network (MHN) recommends that all men get a baseline PSA screening done at age 40. Men in the following high-risk groups should get their baseline PSA screening even earlier:

1) African American men

2) Men with a family history of prostate cancer

3) Vietnam War veterans who were exposed to Agent Orange

We need to change the patient-provider dialogue to include the PSA as a diagnostic tool for early detection. Having an elevated PSA score doesn’t mean that a man must immediately seek a specific treatment. We encourage open communication between patients and their family, partner, provider, and friends.

We must also encourage peer-to-peer conversations about PSA testing. Men should promote screening among their friends, whether they’re out watching the game or playing ball on weekends or at work during the week. A man’s understanding of the importance of PSA screening may change when he hears about it from trusted friends and coworkers who have already been screened.

Thanks to the Internet, social media, and mobile devices, men have access to almost unlimited amounts of information, some of which is accurate, but most of which is not. It’s critical that we ensure that messaging about PSA screening comes from reliable sources (such as MHN) that can answer questions men and their families may have about the procedure beforehand, or explain the results afterwards.

Involving family and partner in research and decisions about PSA screenings is an important way to elevate the conversation. For example, when a man’s partner comes with him to appointments and offers support and encouragement, she’s letting him know that no matter what the outcome, they can get through it together.

There is no reason for men to fear the unknown. A lot of guys convince themselves that if they don’t know about a disease, it won’t kill them. In fact, the exact opposite is true: not finding out about a treatable disease like prostate cancer until it’s too late to treat will end a man’s life far sooner than it should. Early diagnosis of prostate cancer allows for the broadest range of treatment and management options, including active surveillance.

Getting a baseline PSA at an early age will enable a man to quickly respond to any changes and work with his provider to come up with the best treatment game plan for him and his family.

We need to educate both the primary care medical profession (internists, GP's and family practice physicians) as well as the as-yet-undiagnosed prostate cancer patients about the need for early detection of potentially lethal prostate cancer. This means being persuasive and out there with messages about risk of the disease and guidelines for testing and re-testing. This means education about guidelines, PSA and new iterations of PSA and its progeny. This means education about the risks of not timely diagnosing significant and potentially or currently aggressive disease. This means strong and rational arguments to counter the misplaced "D" Recommendation of the United States Preventive Services Task Force (USPFTF). This means public service announcements in women's magazines as well as in publications for men, for veterans, for retirees. This means teaching men how to have an informed discussion with their physicians. This means public service campaigns to target high school boys. This means more events in highlighting men's health issues. This means letters to the editor, white papers, correspondence to thought leaders, and working with top urologists and oncologists to continue fighting this disease.

These will help elevate the dialogue on prostate cancer and reach those likely to benefit from early detection.